Aims To investigate the clearance of blood lactate level in neonates undergoing whole body cooling for hypoxic ischaemic encephalopathy (HIE) related to their outcome.
Methods Retrospective case note review of infants receiving whole body cooling at a tertiary neonatal centre with outcome data enabling grouping into normal or abnormal neurological examination, or death, at follow up. Blood lactate measurements taken at 6, 12, 18, 24, 48, 72 and 96 hours were compared across the outcome groups. Data is given as median (± interquartile range)
Results 61 infants were identified with birth weight 3.31 (2.77–3.55) kilogrammes, gestation 39 (38–40) completed weeks, ten minute Apgar score of 5 (2–6) and arterial cord pH 6.95 (6.82–7.08). 13 infants died, 14 had abnormal and 34 normal neurological follow up at last examination.
Kruskal-Wallis test demonstrated significant differences in blood lactate between the three outcome groups at 6, 12, 18, 24, 48 and 72 hours:
Conclusions In this preliminary study blood lactate measurement shows statistically significant differences for neonatal outcome in terms of death, abnormal or normal examination. This may aid prognostication in infants suffering HIE, and help determine further management.
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